Clin Endosc.  2024 Mar;57(2):237-245. 10.5946/ce.2023.011.

22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions

• Tanisaka Y
• Mizuide M
• Fujita A
• Jinushi R
• Shiomi R
• Shin T
• Sugimoto K
• Tashima T
• Mashimo Y
• Ryozawa S

• KMID: 2553761
• DOI: http://doi.org/10.5946/ce.2023.011

Abstract

Background/Aims
Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions.
Methods
Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S).
Results
A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03).
Conclusions
Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

Keyword

Endoscopic ultrasound; Endoscopic ultrasound-guided fine-needle aspiration; Pancreas; Pancreatic solid lesions

Figure

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  Fig. 1. Franseen needles for endoscopic ultrasound-guided tissue acquisition. (A) Cobalt-chromium Franseen needle. (B) Stainless-steel Franseen needle.

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  Fig. 2. Patient eligibility flowchart. EUS-TA, endoscopic ultrasound-guided tissue acquisition; FNA, fine-needle aspiration.

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  Fig. 3. Endoscopic ultrasound findings. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using cobalt-chromium (CO-Cr) (A) and stainless-steel Franseen needle (B) from the stomach when the elevator of the linear echoendoscope was fully used. Both needles are visible (pink arrows). No significant difference intergroup difference in puncture angles was noted. EUS-TA using Co-Cr (C) and stainless-steel Franseen needles (D) from the second portion of the duodenum when the elevator of the linear echoendoscope was fully used. Both needles are visible (pink arrows). The stainless-steel needles had a greater puncture angle than the Co-Cr needles.

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